Deliberate self harm in adolescents: Self report survey in schools in England

Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford.
BMJ (online) (Impact Factor: 17.45). 12/2002; 325(7374):1207-11.
Source: PubMed


To determine the prevalence of deliberate self harm in adolescents and the factors associated with it.
Cross sectional survey using anonymous self report questionnaire.
41 schools in England.
6020 pupils aged 15 and 16 years.
Deliberate self harm.
398 (6.9%) participants reported an act of deliberate self harm in the previous year that met study criteria. Only 12.6% of episodes had resulted in presentation to hospital. Deliberate self harm was more common in females than it was in males (11.2% v 3.2%; odds ratio 3.9, 95% confidence interval 3.1 to 4.9). In females the factors included in a multivariate logistic regression for deliberate self harm were recent self harm by friends, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem.
Deliberate self harm is common in adolescents, especially females. School based mental health initiatives are needed. These could include approaches aimed at educating school pupils about mental health problems and screening for those at risk.

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Available from: Keith Hawton, Apr 02, 2015
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    • "Community studies of self-harm are vital as the majority of self-harm episodes do not present to clinical services (Hawton, Rodham, Evans, & Weatherall, 2002; Kidger, Heron, Lewis, Evans, & Gunnell, 2012; Ystgaard et al., 2009). However, such studies are subject to a number of limitations such as misreporting and nonresponse (Grimes & Schulz, 2002), which can lead to bias in estimates of prevalence and measures of association. "
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    ABSTRACT: The objective of this study was to examine agreement between self-reported and medically recorded self-harm, and investigate whether the prevalence of self-harm differs in questionnaire responders vs. non-responders. A total of 4,810 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) completed a self-harm questionnaire at age 16 years. Data from consenting participants were linked to medical records (number available for analyses ranges from 205–3,027). The prevalence of self-harm leading to hospital admission was somewhat higher in questionnaire non-responders than responders (2.0 vs. 1.2%). Hospital attendance with self-harm was under-reported on the questionnaire. One third reported self-harm inconsistently over time; inconsistent reporters were less likely to have depression and fewer had self-harmed with suicidal intent. Self-harm prevalence estimates derived from self-report may be underestimated; more accurate figures may come from combining data from multiple sources.
    Full-text · Article · Jan 2016 · Archives of Suicide Research
    • "Our study highlights that female adolescents were more likely to have suicidal and other self-harming behavior and ideation. This finding has been consistently shown in the literature (Hawton et al., 2002). Adolescent depression and hospital-treated self-harm may play a role, as the numbers are higher for female adolescents compared to males (Olfson et al., 2005), Of note is that sex difference did not reach significance levels when the regression was run for the suicide intent and the suicide attempt groups, suggesting that females are more likely to engage in ultimately non-lethal self-harming behavior without suicide intent, in contrast to a previous study where no significant gender difference was found in the frequency, duration or number of methods of NSSI (Nock et al., 2006). "
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    ABSTRACT: Adolescents comprise a unique and often challenging group of patients with diverse presentations to the Mental Health Services; suicidal behavior being one of them. The main aim of this naturalistic project was to investigate demographic and clinical correlates of adolescent suicidal and self-harm events, which may be of value to decision-making in clinical practice. All adolescents (n = 149) registered and actively managed by a specialist community mental health service in South London were included in the study. Clinical information from their files was used to determine suicidality/self-harm events. The Columbia Classification Algorithm of Suicide Assessment (C-CASA) was utilised for classification purposes. Logistic regression was used to explore the effects of age, sex, diagnosis, medication, substance use (alcohol and/or cannabis) and ethnicity on suicidality/self-harming behaviors. Age, sex and use of psychotropic medication were identified to play a significant role in determining the risk of engaging in self-harming behavior. The risk was higher with increasing age and female sex. Medication seemed to have a protective effect. Reporting a 20% prevalence of non-suicidal self-injury (NSSI) in our population, we highlight the importance of NSSI as a distinct diagnostic category. Our findings have implications for risk assessment and appropriate decision-making in clinical settings. Results are translatable and relevant to other metropolitan areas.
    No preview · Article · Jul 2015 · Journal of Mental Health
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    • "Imidlertid viser flere befolkningsundersøkelser at bare et mindretall av de som skader seg selv oppsøker hjelp. Undersøkelser har vist at bare 5–16 % av ungdommer med selvskade (med og uten suicidal hensikt) har vaert innlagt på sykehus etter hendelsen (Hawton et al., 2002; Ystgaard et al., 2003). Det er påvist i en britisk skolebasert undersøkelse at ungdommer som har tatt overdose med tabletter har større grad av suicidal hensikt enn de som kutter seg selv (Rodham et al., 2004), men dette ble ikke påvist i en tilsvarende norsk undersøkelse (Ystgaard et al., 2003). "

    Preview · Article · May 2015
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